Section 205.540  Postoperative Care

a)         Patients shall be observed in the facility for a period of time sufficient to ensure that the patient is awake, physiologically stable, manifests no immediate postoperative complications, and is ready to return to home or to a similar environment.  No patient shall be required to leave the center in less than one hour following the procedure(s).

b)         Rh factor sensitization prophylaxis shall be provided to all Rh negative patients following procedures performed to terminate pregnancy, in accordance with standard medical procedures.

c)         Patients in whom a complication is known or suspected to have occurred during or after the performance of a surgical procedure shall be informed of such condition, and arrangements shall be made for treatment of the complication. In the event of admission to a hospital, a summary of care given in the ambulatory surgical treatment center concerning the suspected complication(s) shall accompany the patient.

d)         To ensure availability of follow-up care at a licensed hospital, the ambulatory surgical treatment center shall provide written documentation of one of the following:

1)         A transfer agreement with a licensed hospital within approximately 15 minutes travel time of the facility.

2)         A statement that the medical director of the facility has full admitting privileges at a licensed hospital within approximately 15 minutes travel time and that he/she will assume responsibility for all facility patients requiring such follow-up care.

3)         A statement that each staff physician, dentist, or podiatrist has admitting privileges in a licensed hospital within 15 minutes travel time of the facility.

e)         Written instructions shall be issued to all patients in accordance with the standards approved by the consulting committee of the ambulatory surgical treatment center and shall include the following:

1)         Symptoms of complications associated with procedures performed.

2)         Limitations and/or restrictions of activities of the patient.

3)         Specific telephone number to be used by the patient, at any time, should any complication or question arise.

4)         A date for a follow-up or return visit after the performance of the surgical procedure, which shall be scheduled within six weeks.

f)          Patients shall be discharged only on the written signed order of a physician.  The name, or relationship to the patient, of the person accompanying the patient upon discharge from the facility shall be noted in the patient's medical record.

g)         Information on availability of family planning services shall be provided, when desired by the patient, to all patients undergoing a pregnancy termination procedure.  When, in the physician's opinion, it is in the best interests of the patient and with the patient's consent, family planning services may be initiated prior to the discharge of the patient.